What Pilots Know That Doctors Don’t

The wind howled across the tarmac, rain pelting the windows of the cockpit. Inside the plane, a pilot meticulously ran through the pre-flight checklist. Despite the storm, their hands were steady, guided by practiced protocols that left no room for oversight. Each detail was verified, double-checked, and confirmed, a testament to a system built on unwavering precision. Pilots grow up in a system that is rigorous about checks, training, and retraining. Surgeons grow up in a system that trains them solely by sheer volume.

There was a time when I trained as a resident that I would not leave the hospital for two or three days at a stretch. That was brutal, beyond humane, but that was the only way superior training could be achieved. I spent hours and hours at patients’ bedside, learning every single minute from them, my seniors, attending surgeons, and senior nurses, through every case, trial, and error. Learning was experiential but on real patients.

I learned my skills because of the sheer volume that I was exposed to. That training made me the surgeon I became. I could think on my feet. I could stay in the operating room for over 15 hours straight. I could think of plan A, B, C, D, and devise methodologies to try to save my patients.

Then, due to human errors, residency training was regulated. Residents were limited to 80 hours a week, whereas I was doing 120-130. Residents were asked to focus more on learning than on the “scut work” that my generation of surgeons thought was necessary.

We did, and we learned. But society did not want to raise surgeons who were brutalized during residency and made errors while being tired. That was the right call.

So how do residents learn now? If one does not train in a very high-volume program, the training is subpar. The alternatives? Books. Computers. Videos. Mental notes.

Compare this to aviation. Training is conducted constantly on simulators that replicate conditions, where stress inoculation is mandatory, and where pilots are required to sharpen their skills, no matter how experienced they are. Training is standardized. Protocols are built in. Virtual reality and extended reality technologies have made this kind of immersive, repeatable training possible in ways that were unimaginable a generation ago.

Society rightly abolished the brutal 130-hour workweeks for surgical residents. After all, surgeons are human. They have families. They have emergencies of their own.

But what replaced that grueling system of apprenticeship?

Books? Computers? YouTube?

Nothing immersive. No virtual reality medical simulation. No way to practice under pressure without putting a patient at risk.

Pilots have simulators. Surgeons have screens. Until now, healthcare has had no equivalent to the flight simulator—no immersive training platform that replicates clinical emergencies and measures whether a provider can actually perform.

It’s like asking a baseball pitcher to learn and practice pitching just by watching YouTube videos. It doesn’t compare.

The Numbers Tell the Story

Aviation carries over 900 million passengers annually in the United States. According to The Global Statistics, U.S. commercial carriers have reported only three fatalities over the past decade, highlighting a remarkable safety record in recent years.

Healthcare sees approximately 35 million hospital admissions per year. Preventable deaths have long been a significant issue, with a staggering 250,000 recorded annually. This makes it the third leading cause of death in America, nearly one in every 140 patients. Over the last decade, these figures have shown only slight fluctuations. Despite various interventions, such as improvements in hospital protocols and increased awareness campaigns, the overall number remains alarmingly high, indicating a system struggling to learn and adapt.

If aviation had healthcare’s safety record, we would see over six million passenger deaths per year. Every airport in America would shut down overnight.

Put another way: 250,000 preventable deaths is the equivalent of 3.8 commercial plane crashes every single day, 365 days a year. If planes were falling out of the sky at that rate, there would be Congressional hearings by noon. The FAA would ground entire fleets. CEOs would resign. The industry would be transformed before the week was out.

In healthcare, we file incident reports and move on. We have root cause analysis, but then nothing.

The Certification Gap

Surgeons know what pilots know—in their respective fields. But do they have the same access to resources?

No.

Surgeons have certifications and recertifications based on multiple-choice questions. Pilots have certifications and verification of competency through systems that create and recreate dire circumstances, inoculate against stress, and demand performance. VR-based competency verification could bring that same rigor to healthcare—replacing paper tests with immersive clinical scenarios that measure real skill under real pressure. Imagine a seasoned surgeon relying on their multiple-choice recertification who missed a critical bleed in a patient post-operatively. The oversight, attributed to the absence of practical, stress-based verification, led to the patient’s rapid decline, underscoring the human cost of such a certification gap.

In aviation, skills are attained and maintained. Certification is an actual act of performance—not situational guesswork.

Surgeons know a lot. But competency is not a metric that is checked.

The Truth No One Wants to Say

Some surgeons don’t realize their skills have declined until others start to notice. By then, patients have already paid the price.

There is no system that tells a surgeon, privately and objectively, that their reaction time has slowed or their precision has drifted. No confidential feedback loop. No safe place to discover your own decay before it becomes someone else’s tragedy. A VR medical simulation training platform with AI-powered competency tracking could change that—providing the private, objective, ongoing assessment that no written exam ever could.

The system doesn’t ask because it doesn’t want to know.

That is why competency tracking and verification are the only way to maintain a standard in healthcare that minimizes human error.

A Different Way to See It

What if competency verification wasn’t something done to surgeons, but something done for them, quietly and with mentorship? A system that tells you where you stand before anyone else notices, acting as a supportive ally rather than a critic. That lets you address decline privately, with dignity. That gives you confidence rooted in evidence, not hope. That protects your patients and your legacy.

Pilots don’t resent the simulator. They rely on it.

That is exactly what immersive medicine promises. Platforms like BLSXR—which brings Basic Life Support training into virtual reality with AI-driven competency verification—represent the beginning of that shift. VR in healthcare training is not a novelty. It is the infrastructure of a safer future.

We took away the brutal path to competence.

Where’s the humane one? VR in medical training is the answer. The technology exists. The question is whether we have the will to use it.